Barber - Sole Proprietor/Partnership Shop Owner Original License


Use and Occupancy Attestation:

A Use and Occupancy permit must be obtained from the local zoning board prior to completing this application.

Your application will not be processed without the Use and Occupancy permit. The Use and Occupancy Permit must be sent to the Board of Barbers within 10 days of submitting this application. If the permit is not received by the Board within 10 days, your application will be denied.

The permit must be sent to The State Board of Barbers, 500 North Calvert St, Baltimore, MD 21202

Have you obtained the Use and Occupancy Permit? Yes
  Date of Permit: - - (MM-DD-YYYY)
  Permit Number:

Personal Information:

Enter business type: Sole Proprietor or Partnership

Sole Proprietor or
Partner #1 Name:
First Middle
Last
Partner #2 Name: First Middle
Last

The following personal information should be for the sole proprietor or partner #1:

I have a United States mailing address
Address:
City, State Zip: , -
County:
I have a mailing address outside the United States
Address:

Social Security Number:
Date of Birth (MM-DD-YYYY): - -
Place of Birth:
I was born in the United States
  City and State: ,
I was born outside the United States
  City and Country:
Gender:         Male Female
Home Phone Number: - -
E-mail Address:

Business Information:

Note: If you change the name of your shop, the outside signage of the business must be changed to match the shop's name. If the names do not match, you are in violation of the Barber Regulations.
Shop Name/Outside Signage:
Shop Address:
City, State Zip: , -
County of Shop Address:
Business Phone No.: - -

Required Information:

Have you ever:
1. Been convicted of a felony or misdemeanor in any State or Federal Court? Yes No
2. Had this type of license, certificate, registration, or permit denied, suspended, or revoked by Maryland or any other jurisdiction? Yes No

Workers Compensation:

 I have Workers Compensation Coverage   Policy/Binder No.

Issued by the  

 I am not an employer required to provide employee coverage under the Workers Compensation Law.


Certification:

By pressing "Submit" below:



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